Cytomegalovirus infection among Human Immunodeficiency Virus (HIV) infected individuals on highly active anti-retroviral therapy in North-Central Nigeria

Abstract

BackgroundCytomegalovirus (CMV) infection is common among HIV-infected individuals. Its contribution to morbidity and mortality became more apparent following introduction of highly active anti-retroviral therapy (HAART) which improved survival among HIV-infected individuals.ObjectivesThis study aimed at determining the prevalence of both active and latent CMV infections among HIV-infected individuals on HAART in Ilorin, Nigeria.MethodsA total of 360 consented HIV-1 patients were recruited for the study. About 5ml of blood and socio-demographic data were collected from each patient. Plasma from the blood was tested for anti-CMV IgM and IgG presence using ELISA.ResultsOf the 360 participants tested, 42 (11.7%) and 265 (73.6%) were respectively anti-CMV IgM and IgG antibodies positive representing active and latent infection rates respectively. Gender and age were the correlates of IgM seropositivity while age, occupation and marital status correlated with IgG seropositivity. Occupation, marital status, use of HAART and CD4+ count were not statistically associated with IgM level while gender, use of HAART and CD4+ count did not correlate with IgG level.ConclusionsThis study has demonstrated high level of latent and active CMV infection among HAART recipients in Ilorin and highlighted the need for incorporation of anti-herpes drugs in the treatment regimen.

Cytomegalovirus co-infection with HIV in children and adolescents on antiretroviral therapy in Abuja, Nigeria

“…Patients in the present study had mean CD4 cell count and ART treatment duration of 958.6±37.8 cells/μl and 6.9±3.4 years respectively, indicating adequate immune response and long duration on ART. Going by the suggestion of Ojide et al, (31) and Udeze et al, (37), the good immunological response of patients in our study and their long duration on ART could possibly explain the non-significant association between prevalence of CMV IgM and CD4 cell count and VL. However, many other studies have shown prevalence of CMV IgM to be significantly associated with CD4 cell count (22,40,41).…”

“…Although the prevalence of CMV IgM was higher among patients with high CD4+ cell counts and low VL in our study, this surprisingly, was not statistically significant. Similar studies in Benin (31) and Ilorin (37) in Nigeria, and in Iran (41) also found no statistically significant association between CD4+ cell count values and prevalence of CMV IgM in their study populations, and adduced such findings to the effects of ART and duration of treatment. Patients in the present study had mean CD4 cell count and ART treatment duration of 958.6±37.8 cells/μl and 6.9±3.4 years respectively, indicating adequate immune response and long duration on ART.…”

“…Musa et al, (22) however had a contrary observation in Kano where they reported more female patients living with HIV having significantly higher CMV IgM than their male counterparts (8.7% vs 4.3%, p<0.01) although no reason for such finding was proffered. Udeze et al, (37) equally found significantly higher primary/ active CMV IgM among males than females HIV-infected children and adults on ART in their study cohort in Ilorin, and attributed such findings to more exposure of males to factors that lead to re-activation or re-infection of CMV in their locality.…”

“…Exposure of children to such centers therefore increase the risk of CMV cross infection from school mates. Other studies however have shown significant association between prevalence of active CMV infection and other age groups (35,37). In the study by Udeze et al, (37), higher IgM was significantly observed among children in age group ≤20 years (p=0.047) among their HIV cohorts aged 1 to 70 years on ART studied at Ilorin.…”

“…Other studies however have shown significant association between prevalence of active CMV infection and other age groups (35,37). In the study by Udeze et al, (37), higher IgM was significantly observed among children in age group ≤20 years (p=0.047) among their HIV cohorts aged 1 to 70 years on ART studied at Ilorin. The authors attributed such significant positive findings to the lower level of education and engagement in risky sexual behaviours in the age group but because the study did not separate the children into different paediatric age groups, it was difficult to appreciate which particular age group among the children had the highest prevalence of CMV IgM.…”